30A Innovations,LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

30A INNOVATIONS,LLC

Doing business as

Freedom Pharmacy

Practice address

3902 Hardy St
Hattiesburg, MS 39402-1541

Phone

(601) 422-7813

NPI assigned

Sep 2, 2013

Last updated

Sep 2, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Michelle ScogginNPI 1831528561

Title

Pharmacist/Co-Owner

Phone

(601) 422-7813

Specialties & licenses 1

Addresses

Other names 1

• Freedom Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michelle Scoggin, PHARMACISTS

  • Pharmacist
  • Hattiesburg, MS
  • NPI 1831528561
  NPD Authorized official
• Brian Christopher Casey, PHARMD

  • Pharmacist
  • Hattiesburg, MS
  • NPI 1831786029
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378080000000",
    "number": "1295169753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16586",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394046586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021541",
            "telephone_number": "601-422-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "30A INNOVATIONS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-02",
        "last_updated": "2013-09-02",
        "status": "A",
        "authorized_official_last_name": "SCOGGIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PHARMACIST/CO-OWNER",
        "authorized_official_telephone_number": "601-422-7813",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.